Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD) is an umbrella term for Crohn’s disease and ulcerative colitis, two conditions that cause chronic inflammation.

Inflammatory GI conditions often share similar symptoms like abdominal pain, blood in the stool, and fatigue. And regardless of which type of IBD you have, living with symptoms can make it challenging to navigate your day-to-day.

Read on to learn about IBD symptoms, causes, risk factors, and complications—and how we can help you find relief.

IBD symptoms

Wondering if your symptoms might be a form of IBD or looking to better understand your condition? Let’s explore some of the signs of inflammatory bowel disease (IBD) and get you the answers you need, whether you’re newly concerned or already have a diagnosis.

IBD symptoms may come and go, with days, weeks, months, or years of remission between flare-ups.

Inflammatory bowel disease (IBD) symptoms can include:

• Abdominal pain or cramping
• Weight loss
• Changes in bowel habits
• Fatigue
• Chronic diarrhea, chronic constipation, or both
• Urgent bowel movements
• Blood with bowel movements
• Mucous in stool
• Feeling of incomplete bowel movements
• Bowel movements at night
• Nausea or vomiting

Ulcerative colitis mainly affects the large intestine and rectum, while Crohn’s disease can occur anywhere in the digestive tract.

Living with IBD symptoms can be uncomfortable, but it’s important to know that you’re not alone. Estimates suggest over 2.3 million adults in the U.S. have an inflammatory bowel disease—and that doesn’t account for those who live with symptoms but have yet to seek help.

At Oshi Health, our GI specialists, including GI providers, registered dietitians, and gut-brain specialists, work together to address the root cause of your IBD symptoms.

You don’t have to live with the discomfort of IBD: Get started on your path to symptom relief in 3 minutes or less!

IBD causes

It’s unclear exactly what causes IBD in some people but not others, but evidence suggests an interaction between the following may be at play:

• Your genetics. Certain genes might increase the chances of developing IBD. Researchers have identified over 200 genes that play a role in IBD. Inflammatory bowel disease also runs in families. However, evidence suggests there’s a greater genetic risk with Crohn’s than ulcerative colitis.
• Your immune system. Inflammatory bowel disease may involve an abnormal immune response—possibly triggered by gut microbes, causing the body to mistakenly attack cells in the digestive tract. This causes gut inflammation that leads to uncomfortable GI symptoms.
• Your environment. Researchers are also looking into how the world around you might interact with your unique genetic makeup, gut microbiome, and immune system to trigger IBD.

Stress doesn’t cause IBD, but research suggests stress (hello, gut-brain connection) may worsen inflammation and trigger symptoms.

IBD risk factors

Just because you have a risk factor doesn’t mean you’re destined to get IBD, but it can mean you’re more likely to develop the condition than someone else.

IBD risk factors include:

• Being a smoker (specifically for Crohn’s disease)
• Having a parent or sibling with an inflammatory bowel disease (IBD)
• Being younger than 35 (the typical age range when IBD gets diagnosed—but some people go longer without getting a diagnosis and onset can happen at any age)
• Being Caucasian, especially of Ashkenazi (Eastern European) Jewish descent, though IBD can affect people of all ethnicities
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs), which can also worsen the disease

Where you live may also play a role in IBD since it’s more likely to affect people living in northern climates, high-income countries, and big cities.

IBD complications

Before we dig into this scary stuff, we want to make sure you know that just because you have inflammatory bowel disease doesn’t mean you’ll develop complications. Seeking treatment for your IBD and managing your symptoms can make you less likely to experience serious side effects.

Over time, untreated ulcerative colitis and Crohn’s disease can damage the lining of your intestine, leading to serious IBD complications such as:

• Inflammation outside the GI tract. IBD inflammation starts in your GI tract but it can also affect your eyes, skin, and joints.
• Intestinal obstructions and other structural complications. Depending on IBD type, chronic inflammation can potentially cause strictures, fistulas, fissures, obstructions, abscesses, and perforations of the GI tract.
• Anemia. Because IBD can cause bleeding and inflammation, it can also lead to a red blood cell deficiency known as anemia.
• Dehydration. Severe diarrhea due to ulcerative colitis or Crohn’s can lead to dehydration that may require medical treatment.
• Developmental problems. In kids, IBD can impact growth and even delay puberty—which is why it’s commonly diagnosed before most people hit their 30s.
• Osteopenia or osteoporosis. Both IBD and certain IBD treatments, like corticosteroids, can impact bone health.
  Blood clots. Having IBD can put you at a higher risk of developing blood clots.

Having IBD may also increase your risk of developing colorectal cancer—the risk is higher with untreated IBD. Read more about this link in our blog: How IBD affects your colorectal cancer risk.

Curious about your colon cancer screening options? Connect with an Oshi Health GI specialist to find which screening option is right for you.

Read more about potential complications that can arise due to IBD—and how to reduce your risk—in our condition guides to ulcerative colitis and Crohn’s disease.

IBD diagnosis

The first step toward an IBD diagnosis is a thorough medical history. At Oshi Health, our GI specialists consider the whole you when working together to make a diagnosis, including your medical history, symptoms, and lifestyle.

Your provider will ask you questions about your symptoms, like when your symptoms started, bowel changes typically occur, or whether certain foods or behaviors tend to make certain symptoms worse.

They’ll also consider the following:

• Your family history
• Your diet
• Lifestyle habits
• Any medications or supplements you’re taking or have tried for your symptoms
• Stress and behavioral health
• Previous surgeries or medical procedures

And while you don’t need to have had previous testing to meet with an Oshi provider and benefit from our integrated GI care, your provider will review any previous testing you’ve gone through, if any.

They may also recommend additional testing if you have a combination of risk factors, including a family history of colorectal cancer, or serious symptoms like:

• Unexplained weight loss
• Blood or blood clots in your stool
• Severe abdominal pain that doesn’t go away
• A high fever
• Diarrhea at night

Further testing might include:

• Blood tests Blood tests can check for signs or complications of IBD, including low red blood cell count, which may signal anemia.
• Stool tests Stool tests look for other potential underlying causes that may explain your symptoms, like an infection. Stool tests can also help determine whether there is inflammation in your lower digestive tract.
• Endoscopy Two types of endoscopy help healthcare professionals visualize the large intestine: colonoscopy and flexible sigmoidoscopy.
  
  These tests can:
  Check for signs of IBD
  Determine IBD severity
  Rule out other GI conditions
  
  During an endoscopy, a healthcare professional may take a tissue sample (biopsy) to check for abnormalities.
  
  A newer, less invasive endoscopy procedure, capsule endoscopy, requires you to swallow a capsule containing a tiny camera. This allows healthcare professionals to view the inside of your digestive tract via a wearable receiver.
• Imaging studies such as a computed tomography (CT) This type of imaging uses X-ray and computer technology to produce images of your GI tract. In some cases, you may need to drink a solution and receive a contrast dye infection to produce clearer images of the inside of your body. or magnetic resonance imaging (MRI) scan

While some forms of testing, like a colonoscopy, might be necessary for diagnosis, we try to avoid putting you through unnecessary and repeat testing. If our providers recommend diagnostic or other testing, we take a concierge approach to help you find a convenient and in-network location.

IBD treatment

We take a comprehensive approach to inflammatory bowel disease (IBD) treatment, by treating the disease and addressing diet and lifestyle factors that can contribute to symptom flare ups.

Here’s how our providers work together to put you on a path to better digestive health:

Prescribing or recommending medications

Medications are often part of personalized treatment plans for IBD at Oshi Health. Your provider will recommend medications based on the type of IBD you have, disease severity and location, and other factors unique to you.

Medications can help relieve symptoms during Crohn’s and ulcerative colitis flares and prevent future flares by helping to put you in remission.

Your provider can also prescribe medications to help manage uncomfortable symptoms, like mild pain due to IBD.

Medications are just one piece of the journey to symptom relief. Our whole-person approach to GI care also looks at lifestyle factors such as diet and stress that may be contributing to symptom flares.

Identifying triggers & making dietary and lifestyle adjustments

What does your typical diet look like? Do you have dietary triggers that seem to trigger flares or make your symptoms worse?

Our registered dietitians will help you identify your IBD-trigger foods and find ways to modify your diet without necessarily giving up the foods you love.

Your diet might look different depending on whether you’re in a flare or remission. Our RDs offer personalized recommendations based on your unique needs to make sure you’re well-nourished.

Depending on what triggers IBD symptoms for you, management might also involve:

• Focusing on increasing your soluble fiber intake to ease diarrhea
• Eating smaller, more frequent meals
• Chewing more thoroughly to reduce your risk of bowel obstruction
• Limiting FODMAPs in your diet
• Incorporating a GI-gentle diet when you’re experiencing a flare
• Adopting a Mediterranean diet

Working on the gut-brain connection

Did you know your brain and digestive system are in constant communication? It’s why you might feel butterflies in your stomach when you experience heightened emotions like stress or excitement.

The close link between your gut and mind can also play a role in gut health conditions like IBD.

Living with a chronic condition like IBD can be incredibly stressful. Stress can actually make your symptoms worse, creating a vicious cycle where stress and GI discomfort feed off each other.

Our gut-brain specialists can help you identify potential stress-related triggers causing excess inflammation that leads to symptom flares. They can also help you cope with the emotions that come hand in hand with living with a chronic condition.

Gut-brain specialists are trained and licensed behavioral health professionals with specific experience treating GI concerns like IBD. Working alongside GI providers and registered dietitians, they can help you take control of your symptoms by providing you with the skills and tools to cope with distressing thoughts, feelings, and physical reactions that may be contributing to GI distress.

This might include:

• Relaxation strategies to manage stress, including diaphragmatic breathing exercises, mindfulness meditation, and exercise
• Cognitive behavioral therapy (CBT) for GI symptoms to help you better cope with negative emotions relating to your condition, including feelings of embarrassment and shame
• Acceptance and commitment therapy (ACT) for GI conditions to move towards a place of acceptance and identify the ways you might be avoiding certain situations, which could make it more challenging to cope with symptoms

Oshi Health gut-brain specialists are here to support you as you navigate living with a chronic digestive health condition, helping to normalize and validate your GI-related concerns—so you never feel alone in your journey to symptom relief.

Whole person care for IBD

At Oshi, no two treatment plans are the same.

Our GI specialists work together to create a personalized treatment plan to address the root cause of your symptoms. We consider the whole you—not just your IBD diagnosis. That means taking into account diet, lifestyle, and the gut-brain connection, ensuring you get the individualized care you need.

Already seeing a GI provider? We can provide support between visits and work with your existing gastroenterologist as an extension of your care.

Ready to take control of your inflammatory bowel disease (IBD) symptoms? We’re here for you every step of the way with virtual, next-day appointments. Get Started with Whole Person Care for IBD Today!

Steph Coelho Written by Steph Coelho

Medically reviewed by Andrea Onstad, APRN, CNP